中晚孕期胎儿静脉导管A波倒置与胎儿心脏畸形  

Reversed A-wave in fetal ductus venosus and fetus cardiac abnormalities during the 2^(nd) and 3^(rd) trimester

作　　者：韩建成[1] 何怡华[1] 张烨[1] 孙琳[1] 刘晓伟[1] 谷孝艳[1] 李治安[1] 

机构地区：[1]首都医科大学附属北京安贞医院超声科,北京100029

出　　处：《中国介入影像与治疗学》2014年第2期100-102,共3页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学基金(81171350);北京市自然科学基金(7122059)

摘　　要：目的探讨中晚孕期胎儿静脉导管A波倒置的临床诊断价值。方法选取资料完整的静脉导管A波倒置胎儿27胎,分析胎儿先天性心脏畸形特点,并与尸体检查及新生儿随访结果相对照。结果 27胎静脉导管A波倒置胎儿中,右心系统发育异常20胎(20/27,74.07%),其中右心发育不良综合征13胎,肺动脉瓣狭窄并三尖瓣重度反流3胎,Ebstein畸形并三尖瓣重度反流2胎,三尖瓣黏液样变性并重度反流1胎,单纯肺动脉瓣轻度狭窄1胎;锥干畸形5胎(5/27,18.52%),其中右心室双出口2胎,永存动脉干1胎,法洛四联症1胎,功能矫正型大动脉转位1胎;扩张型心肌病1例;卵圆孔血流受限1例。结论静脉导管A波倒置高度提示胎儿右心系统发育不良或胎儿锥干畸形。Objective To explore the clinical significance of reversed A-wave in the fetal ductus venosus during the second- and the third-trimester. Methods Twenty-seven fetuses with reversed A-wave in the fetal ductus venosus were enrolled, and the features of cardiac abnormalities were analyzed with comparison to the results of autopsy and neonatal fol- low-up. Results Among all 27 fetuses, 20 fetuses （20/27, 74. 07%） had hypoplasia of right heart system, including 13 associated with hypoplastic right heart syndrome, 3 with pulmonary stenosis and severe tricuspid regurgitation （TR）, 2 with Ebstein anomaly and severe TR, 1 with myxomatous degeneration and severe TR, 1 with pulmonary valve stenosis. Five fetuses （5/27, 18.52%） were found with conotruncal anomalies, including 2 with double outlet right ventricle, 1 with persistent truneus arteriosus, 1 with tetralogy of Fallot, 1 with corrected transposition of the great artery. Additionally, there was 1 fetus with dilated cardiomyopathy and 1 fetus with restricted foramen ovale. Conclusion Reversed A-wave in fetal ductus venosus during the second- and third-trimester strongly suggest hypoplasia of right heart system and conotruncal abnormalities.

关 键 词：胎儿心脏 静脉导管 先天性畸形 超声检查 产前 超声心动描记术 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]